Czechia’s centralised medicines purchasing plan sparks concern

A controversial proposal by Czech Finance Minister Zbyněk Stanjura (ODS, ECR) to introduce centralised purchasing of certain medicines by health insurance companies has drawn criticism from healthcare professionals, patient organisations, and pharmaceutical industry representatives.

Critics warn that the plan could restrict treatment options, limit doctors’ autonomy, and increase the risk of drug shortages and corruption.

The proposed changes, included in amendments to the Public Health Insurance Act, would require insurers to procure certain medicines for the entire country through a single tender process.

Hospitals and specialised centres, which currently select treatments based on their needs and those of their patients, would instead be limited to one drug chosen by insurers.

According to stakeholders, this proposal contradicts state efforts to strengthen market resilience against drug shortages.

In a press briefing, David Kolář, executive director of the Czech Association of Innovative Pharmaceutical Industry warned: “Instead of improving medicine availability and reducing dependency on supply chains, it does the opposite – destabilising the system and jeopardising pharmaceutical market stability and treatment accessibility for years to come.”

Experts argue that centralised procurement would undermine medical decision-making. Currently, doctors prescribe treatments based on individual patient needs, clinical experience, and the specifics of each illness.

Efficacy first

Under the new system, price rather than medical efficacy would determine which drugs are available.

Patient organisations fear that economic pressures, rather than medical necessity, will dictate treatment choices.

“Many patients undergo long-term treatment with therapy tailored to their needs. If their medication is changed solely because an insurer won a tender for a different drug, it could have serious health consequences,” cautioned Šárka Slavíková, chair of the patient organisation Amelie.

The proposal also raises concerns about drug availability in the event of supply disruptions.

“Ironically, we are moving in a direction that the rest of the EU is abandoning. The European Commission is now advocating for medicine procurement from multiple suppliers, considering factors beyond price,” noted Filip Vrubel, director of the Czech Association of Pharmaceutical Companies.

In addition to concerns over patient care, critics highlight the proposal’s lack of transparency and its potential to create opportunities for corruption. Hospitals currently procure medicines under clear public procurement regulations, ensuring accountability and fairness. However, the proposed amendments contain no such safeguards.

Finance ministry expects cost savings

The Czech Finance Ministry argues that the reform is necessary to control rising public health insurance costs. “The main reason for this proposal is to achieve savings in public health insurance expenditures,” said ministry spokesperson Stefan Fous in an interview with Czech healthcare news site ‘Zdravotnický deník’.

Although the original proposal was withdrawn after discussions with the health ministry, the finance ministry has confirmed plans to reintroduce it. This time, it will be split into two separate amendments, but it will maintain its original substance.

“The ministry is responding to the current state of public health insurance and the financial outlook for health insurers in 2025 and beyond. The public health insurance system has been running deficits of several billion Czech crowns annually, depleting its reserves and weakening its financial sustainability,” Fous explained.

The Czech General Health Insurance Company has also expressed support for the proposal. According to its Deputy Director for Healthcare, Jan Bodnár, the reform could lead to both cost savings and greater transparency.

[Edited by Vasiliki Angouridi, Brian Maguire]